¿Se fracturan la cadera los hombres y las mujeres ante los mismos factores de riesgo? / Do men and women have the same risk factors for hip fractures?

Fundamento y objetivo. La osteoporosis ha sido considerada una enfermedad de la mujer, sin embargo hoy se sabe que también tiene gran importancia en el sexo masculino. Es una enfermedad multifactorial, cuyo principal factor de riesgo independiente para padecer fracturas, en general, y de cadera en particular, es la masa ósea, aunque otras circunstancias, independientes de ésta, también son relevantes. Este estudio pretende conocer si los hombres y las mujeres presentan fractura de cadera con un mismo nivel de masa ósea y si cuentan con los mismos factores de riesgo asociados a la enfermedad. Pacientes y métodos. Se estudiaron 105 pacientes con fractura de cadera no traumática y 68 controles, en los que se analizan distintos factores de riesgo incluyendo datos clínicos, estilo de vida, analíticos, relacionados con el metabolismo óseo y hormonas sexuales, así como valoración de masa ósea. Resultados y conclusiones. Los valores de densidad mineral ósea (DMO) determinados a nivel de cadera constituyen el principal factor de riesgo de fractura osteoporótica de cadera en ambos géneros, que son comparables cuando se expresan en términos de densidad volumétrica. En las mujeres los factores de riesgo determinantes de la aparición de fractura son el antecedente de fractura no traumática a edad mayor de 50 años, la DMO de cadera total, los niveles de calcio sérico y la toma o no de tiazidas; mientras que en los varones, sólo alcanza significación estadística la DMO de cadera total(AU)

Background and aims. Osteoporosis has been traditionally considered as a disease in women. However, it is now known that this condition is also important in men. It is a multifactor condition whose main independent risk factor to suffer fractures, in general, and those of the hip, specifically, is bone mass. Nonetheless, there are other independent risk factors of importance. This study has aimed to study if men and women suffer hip fractures with the same bone mass and if they have the same risk factors associated to this condition. Patients and methods. We studied 105 patients with non-traumatic hip fracture and 68 healthy controls. The different risk factors were analyzed, including clinical data, lifestyle, analytic data, data related to bone metabolism and sex hormones as well as a complete bone evaluation. Results and conclusions. Hip bone mass density (BMD) values are the main risk factor for osteoporotic fractures in both genders. These values are comparable when expressed in terms of volumetric density. In women, risk factors that determine the appearance of fractures are previous non-traumatic fractures when they are older than 50 years, total hip BMD, serum calcium levels and thiazide intake while in men only total hip BMD reaches statistical significance(AU)

[Do men and women have the same risk factors for hip fractures?]. / ¿Se fracturan la cadera los hombres y las mujeres ante los mismos factores de riesgo?

BACKGROUND AND AIMS: Osteoporosis has been traditionally considered as a disease in women. However, it is now known that this condition is also important in men. It is a multifactor condition whose main independent risk factor to suffer fractures, in general, and those of the hip, specifically, is bone mass. Nonetheless, there are other independent risk factors of importance. This study has aimed to study if men and women suffer hip fractures with the same bone mass and if they have the same risk factors associated to this condition. PATIENTS AND METHODS: We studied 105 patients with non-traumatic hip fracture and 68 healthy controls. The different risk factors were analyzed, including clinical data, lifestyle, analytic data, data related to bone metabolism and sex hormones as well as a complete bone evaluation. RESULTS AND CONCLUSIONS: Hip bone mass density (BMD) values are the main risk factor for osteoporotic fractures in both genders. These values are comparable when expressed in terms of volumetric density. In women, risk factors that determine the appearance of fractures are previous non-traumatic fractures when they are older than 50 years, total hip BMD, serum calcium levels and thiazide intake while in men only total hip BMD reaches statistical significance.

[Continuity of medical care. Evaluation of a collaborative program between hospital and Primary Care]. / Continuidad asistencial. Evaluación de un programa de colaboración entre Atención Hospitalaria y Atención Primaria.

The patients being treated in our health care system are becoming increasingly older and have a greater prevalence of chronic diseases. Due to these factors, these patients require greater and easier accessibility to the system as well as continuity of medical care. Collaboration between the different levels of health care has been instrumental in the success of the system and has produced changes in the hospital medical care protocol. Our hospital has developed a care model oriented towards the patient's needs, resulting in a higher grade of satisfaction among the medical professionals. In this paper, we have given a detailed description of part of our medical model, illustrating its different components and indicating several parameters of its evaluation. We have also reviewed the current state of the various models published on this topic. In summary, we believe that this medical care model presents a different approach to management that benefits patients, medical professionals and the health system alike.

Continuidad asistencial. Evaluación de un programa de colaboración entre Atención Hospitalaria y Atención Primaria / Continuity of medical care. Evaluation of a collaborative program between hospital and Primary Care

Los pacientes atendidos en nuestro sistema sanitario tienen cada vez más edad y mayor prevalencia de enfermedades crónicas. Estas características de salud han condicionado que entre las expectativas de mayor relevancia de los pacientes, se indiquen la accesibilidad al sistema y la continuidad en los cuidados. La colaboración entre los distintos niveles asistenciales ha sido una herramienta reconocida que facilita la consecución de estas expectativas, provocando cambios en la organización del trabajo. Nuestro hospital ha desarrollado un modelo de atención sanitaria que ­en su orientación al enfermo­ facilita la colaboración entre los distintos niveles asistenciales, consiguiendo un grado de satisfacción de los profesionales elevado. En este trabajo se describe detalladamente parte del modelo, mostrando los elementos que lo caracterizan, indicando algunos parámetros de la evaluación de resultados y revisando la situación de los modelos de continuidad asistencial publicados. En resumen, consideramos que este sistema asistencial está dotado de elementos de gestión que permiten atender las expectativas de los usuarios, aportando beneficios para el paciente, el profesional y el sistema sanitario (AU)

The patients being treated in our health care system are becoming increasingly older and have a greater prevalence of chronic diseases. Due to these factors, these patients require greater and easier accessibility to the system as well as continuity of medical care. Collaboration between the different levels of health care has been instrumental in the success of the system and has produced changes in the hospital medical care protocol. Our hospital has developed a care model oriented towards the patient's needs, resulting in a higher grade of satisfaction among the medical professionals. In this paper, we have given a detailed description of part of our medical model, illustrating its different components and indicating several parameters of its evaluation. We have also reviewed the current state of the various models published on this topic. In summary, we believe that this medical care model presents a different approach to management that benefits patients, medical professionals and the health system alike (AU)

[Opsoclonus secondary to encephalopolyradiculoneuritis due to Mycoplasma pneumoniae]. / Opsoclonus secundario a encefalomielopolirradiculoneuritis por Mycoplasma pneumoniae.

Opsoclonus is characterized by sudden onset of arrhythmic, multidirectional chaotic eye movements, generally associated with a parainfectious or paraneoplasic condition. Opsoclonus is a rare manifestation with no known link with infection by Mycoplasma pneumoniae. We present a case of a 23 year old male patient who presented fever, myalgia, vomiting, respiratory failure, opsoclonus and symmetric flaccid tetraparesis with important lower limb muscle atrophy. Serology and seroreversion for M. pneumoniae were both positive. This case illustrates the possibility that M. pneumoniae may produce a predominantly neurological disease and the need to include this infection in the differential diagnosis of opsoclonus, or polyradiculoneuritis.